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I have noticed that there are a lot of clinics now offering SMP and each day there seem to be more. I am looking into having it done. In reflection I like the competition but I don’t like it because it gets confusing. Can you help me here? What’s the difference between what you offer and what a tattoo shop can do?

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There appear to be many clinics that are offering Scalp Micropigmentation (SMP), but the word “clinics” may be confusing. These clinics may not have any medical affiliation and many of them are tattoo parlors with a more “upper crust” office decor. First of all, tattooists can not administer anesthesia, as only an medical doctor (MD) is allowed to use anesthesia, so you would have to endure pain when SMP is done by a tattooist. When you see us,you get examined by an MD, interviewed by an MD, and evaluated by an MD. When the SMP process is done, the doctor is integrally involved in every part of the process, from giving the anesthesia to actually performing parts of the procedure.

These MDs are assisted by medical technicians who fully understand sterile techniques. We are careful about the pigments we use, for example, and although we purchase them in sterile bottles, we re-sterilize them to assure that there are no living bacteria in the bottles. When this is combined with sterile management, you are assured that your risk of infection is minimized. On the other hand, not uncommon risks and complications in the hands of those tattooists who were not trained in sterile techniques and may be sloppy in the delivery of SMP, include:

  1. infection, where reported outbreaks of non-tuberculous mycobacterial infections associated with contaminated tattoo inks have raised questions about the adequacy of packaging, sterilization, the use of dirty or reused needles, and faulty techniques at the tattoo-parlor level
  2. mycobacterium chelonae infection
  3. allergies to the component in the pigments producing scarring, granulomas from foreign body reactions
  4. MRI complications, such as swelling and pain from the metals in the pigments when exposed to the powerful MRI magnets

It has been reported that unsterile tattooing equipment and needles can transmit infectious diseases, such as HIV, hepatitis, and skin infections caused by staphylococcus aureus (“staph”) and other bacteria. This discussion alone should call attention to the need to have the process done by experienced MDs in this field.

For us in particular, we have taught this process at medical meetings to many doctor. At one of these meetings, we have given a course on the do’s and don’ts of the process. Although being a doctor delivering the service protects you from the infections discussed above, there is really no way a doctor can learn this process other than to get trained by another knowledgeable doctor. We have trained doctors in our office along with their technical staff. We have also published articles in medical journals on the subject. To say the least, we have the credentials to do it. Now we have five doctors involved in the process — three in Korea and two in Los Angeles.

Tags: smp, scalp micropigmentation, tattoo, hairloss, hair loss


Snippet from the article:

Disease-causing bacteria can linger on surfaces commonly found in airplane cabins for days, even up to a week, according to research presented at the annual meeting of the American Society for Microbiology.

“Many air travelers are concerned about the risks of catching a disease from other passengers given the long time spent in crowded air cabins,” says Kiril Vaglenov, of Auburn University who presented the data. “This report describes the results of our first step in investigating this potential problem.”

In order for disease-causing bacteria to be transmitted from a cabin surface to a person, it must survive the environmental conditions in the airplane. In the study Vaglenov and his colleagues tested the ability of two pathogens, methicillin-resistant Staphylococcus aureus (MRSA) and E. coli O157:H7 to survive on surfaces commonly found in airplanes. They obtained six different types of material from a major airline carrier (armrest, plastic tray table, metal toilet button, window shade, seat pocket cloth, and leather), inoculated them with the bacteria and exposed them to typical airplane conditions.

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Read the rest — Harmful bacteria can linger on airplane seat-back pockets, armrests for days

I believe that an additional study needs to be done on hair recirculation on airlines. If one person has a flu type syndrome or other diseases such as tuberculosis, the diseases are spread as the air recirculates in the airplane. How many times have you had a friend or family member get sick after flying? Should our fear of flying extend to these situations?

Tags: staph, airplane, flying, bacteria, disease


Its pretty interesting to see that you are investigating this whole ACELL thing. I was kinda wondering one day if you would be one of the DOCs to have this Acell cross your mind. I just ran into this whole page doing a daily Google study on Acell and the usual Hair loss deal and saw that yeah you are thinking about it. Good to see.

Would it make sense to use Acell injections/Powder in the donor area after a strip or FUE procedure as well as Acell into the transplant area such as the frontal hairline area, etc? I have read that it helps the wounds heal faster and the scar feels better when healed With ACell then if healed naturally. IF you said that you saw that it had value in the scar area after a strip procedure. Would it then also have the same value in the transplanted area where it would cause the tiny pin holes after the hair follicle is grafted to heal faster and be less present? As well as help heal the tiny holes after a FUE procedure in the donor area where the follicle was removed. In theory In the long run, would it show almost no scaring anywhere after any type of transplant. Weather its a strip or fue?

I know all the hype is about cloning this and that and plucked hairs growing everywhere. but in the sense where it promotes rapid healing and helps the scar look/feel more natural or show almost no scarring at all. IS that not a great value to the whole hair transplant community?

There are a bunch of cases where grafts that were installed were driven into deep and look like indents after all is done and healed. Im speaking from my own experience from a procedure. Those little bastards are ugly so would that Acell bacon compound help that case as well?

So ACell alone without FRP or whatever they call it for faster healing and better cosmetic scar results seem like a very realistic and valuable thing

Things in life like this interest me. Especially When i read about things that come out like Acell and other medical devices that could potentially help people with hair loss and hair surgery

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ACellIt it generally thought that ACell will help the healing process deep in the wound and possibly reduce the superficial scarring, thereby making better wounds. There is circumstantial evidence for this in our practice, but this is more conjecture than science. I have not seen that ACell has helped the graft healing or made it grow better.

In our practice we have been using ACell for donor wound for over 3 years in most of our patients on a daily basis. Subjectively, the donor wound does look better with less tactile feel of a scar, so it may have some use in reducing keloid formation. Some patients came back for repeat surgeries and the old ACell scar seem to look better, but it was not a drastic improvement. Note that this is just a subjective observation from both the patient and doctor. ACell did not really have a reduction in the overall scar width and it does not make the scar any smaller in our observation. In one or two cases, the patient (who had prior non-ACell surgeries) thought it made the scarring worse. Even I (Dr. Rassman) had ACell put in my donor wound for strip surgery, but it made no difference in scarring compared to prior surgeries. ACell does not promote faster healing in our experience.

We also used ACell in many years ago in graft growth and even possible replication in recipient area. We submitted and applied for research approval with the medical board and conducted studies with Dr. Bernstein in New York. In the end, it didn’t work. The claims were false. To date, no one was able to replicate the claims of hair regeneration. Simply put, it was a publicity hype for the hair transplant world.

Tags: acell, hair multiplication, hair cloning, hair transplant, wound healing


I am 17 years old and experiencing heavy signs of MPB, receding hairline, receding temples, Shedding and thinning. I understand that DHT is what causes hair loss in men, but DHT is also known to be the primary catalyst for penile growth. I am currently still growing (bones) and developing sexually (penis growth facial/pubic hair Etc).

My question is will DHT blocking shampoos block DHT in the body, specifically the DHT responsible for penis growth? Or do the shampoos only block DHT locally in the scalp? I don’t want this shampoo to interfere with DHT pathways and the metabolizing of testosterone into DHT (DHT attaching to androgen receptors etc).

I realize there are numerous factors that influence penile growth but I don’t want to hinder my penis growth at such an age, resulting in a less developed penis than what my genetic blueprint has set out for me. Thank your for your time, its highly appreciated.

The DHT shampoo i had in mind contains Ketoconazole DHT inhibitor, saw palmetto, emu oil, biotin & salicylic acid

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DHT blocking shampoos probably don’t work to treat hair loss, and certainly not systemically. Some people claim that ketoconazole shampoo regrows hair, but it’s just a good antifungal treatment as far as I’m concerned.

Moreover, I don’t believe that these shampoos will impact the size of your penis. At 17 years old, you’ve likely completed puberty by now (or close to it).

Tags: teenager, hairloss, hair loss, dht, shampoo, nizoral, ketoconazole


Snippet from the article:

Prostate cancer might be a sexually transmitted disease caused by a common infection, according to a study. Experts say the research has limitations and is not proof, though.

Scientists at the University of California found evidence of a link between prostate cancer and the STD trichomoniasis, in which a common parasite is passed on during unprotected sexual contact.

The parasite is believed to infect around 275 million people worldwide. Furthermore, over three-quarters of men harboring it have no symptoms and may not seek treatment, resulting in chronic inflammation of the prostate.

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Read the rest — Prostate Cancer ‘Could Be Transmitted Sexually’

The prostate cancer/STD link isn’t confirmed and the article points out that this research was done in a lab setting (not in actual patients). As always, more research is needed.

Tags: std, trichomoniasis, prostate cancer, disease


NEJMAs I’ve written in the past, I’m involved in an email group with some of the industry’s top surgeons. One of the topics that was recently brought up was a case where a patient was told, emphatically, not to take finasteride due to an increased cancer risk. Coincidentally, I received an email from a patient not too long ago with a similar concern… so I figured it was time to write about it again.

In a 2013 article published in the New England Journal of Medicine, the long term survival of participants in the prostate cancer prevention trial was discussed. It was reported that there was no increased in risk of death for those on finasteride compared to a placebo group. There was, however, a marked decrease in the overall incidence of prostate cancer in the treated group as compared with the placebo group. This was consistent with the original studies on the reduction of cancer incidence by as much as 25% for those who were treated with finasteride.

There’s a good breakdown of that NEJM article found at

Tags: finasteride, prostate cancer, propecia, proscar, hairloss, hair loss


Im a 21 year old male and my family doesn’t have much history of early balding. However im experiencing thinning on the back of my head in two spots on each side of the spiral. Also sometimes ill have some sensitivity and have small sore bumps in these areas. My hair line is not receding.

If you can help I would be very grateful. Thank you.

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I think you should see a doctor, as I’m not sure how I can help you via the Internet with a simple description.

What you’re describing could be an infection or some type of balding, but I have no way to know. Sensitivity and sore bumps lead me to believe it’s something that a dermatologist should have a look at. You can find a dermatologist in your area here.

Tags: hairloss, hair loss, bumps, dermatology


Snippet from the press release:

The U.S. Food and Drug Administration, in partnership with other federal and international agencies, took action this week against websites that sell potentially dangerous, unapproved prescription drugs to U.S. consumers. The FDA and the U.S. Customs and Border Protection (CBP) also conducted extensive examinations at U.S.-based international mail facilities, where many packages containing prescription drugs enter the U.S., and found that most of the examined packages contained illegal prescription drugs that had been ordered from online sources.

These actions took place in support of the 7th annual International Internet Week of Action (IIWA) — May 13 to May 20, 2014 — sponsored by Interpol, and also known as Operation Pangea VII. During Operation Pangea VII, law enforcement, customs, and regulatory authorities from 111 countries collaborated to identify the makers and distributors of illegal drug products and medical devices that used the Internet to sell their products and remove these products from the supply chain.

Operation Pangea VII‘s coordinated efforts at mail facilities resulted in the detention or seizure of 19,618 packages containing medicines purportedly from Australia, the United Kingdom (UK), New Zealand and Canada. These packages actually contained unapproved or suspected counterfeit drugs from other countries, such as India, China, Singapore, Taiwan, Mexico, Laos, Malaysia, as well as Australia, New Zealand and the UK.

The FDA and the CBP inspected packages at the mail facilities in Los Angeles, New York and Chicago, and detained or seized 583 packages. Preliminary findings show that certain drug products from abroad, such as insulin, estrogen, bimatoprost, human chorionic gonadotropin, tramadol, tadalafil and sildenafil citrate were on their way to U.S. consumers. The FDA also notified Internet service providers, domain name registrars and related organizations that 1,975 websites were selling products in violation of U.S. law.

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Read the rest — FDA targets illegal online pharmacies in globally coordinated action

Tags: fda, illegal drugs, medication, bimatoprost


Hello, im an 18 year old male and was unlucky enough to be born with not a great hairline to begin with. Now however i notice that my hairline has become a lot worse on one side than the other. Is this natural? And also what would you recommend for treatment? i am already on regaine at the moment which seems to have help a bit and stopped hairloss for now. But would you consider a hair transplant?

it wouldn’t take many hairs being transplanted to have a huge effect on my self-esteem, how many do you reckon?

Please help, it can be really depressing at times, thanks!

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You need an evaluation and a Master Plan. At this point, you really don’t know what type of hair loss pattern you have or if you will bald further than the frontal corners. If were to have surgery without a Master Plan with everything under consideration, you could end up with two patchy corner areas of hair and a bald head some years down the line.

You might just be developing a mature hairline or it could be early genetic loss. There’s no way for me to know what you’re seeing or what your treatment options are without an examination. At 18 years old with some hairline corner recession, I wouldn’t anticipate surgery being the recommended path at this time.

Address your depression and self-esteem by educating yourself and seeing a doctor for an examination and a Master Plan of your options.

Tags: hairloss, hair loss, teen, teen hair loss


Sir, I am a male at 48 years old and still have a fine head of hair. i wash it everyday and eat healthy and take regular exercise. is it possible that i have not inherited the baldness gene? and there is a good chance that i will keep for hair for life?

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If you do not have any signs of balding at 48 years old, you have a way better-than-average chance of not inheriting genetic male pattern baldness. Most people with genetic hair loss see the impact well before the age of 40.

I can’t, of course, guarantee that you’re 100% safe from any hair loss — but it’s not common to develop it at your age.

Tags: hairloss, hair loss, age


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